肝胆胰外科杂志2017，Vol.29Issue(6)：444-448,5.DOI:10.11952/j.issn.1007-1954.2017.06.002
腹腔镜经胆囊管胆道探查术治疗肝外胆管结石的疗效分析
Curative effect analysis of laparoscopic bile duct exploration through cystic duct for the treat- ment of extrahepatic bile duct calculus
摘要
Abstract
Objective To investigate the curative effect of laparoscopic bile duct exploration through cystic duct for the treatment of extrahepatic bile duct calculus. Methods A total of 140 patients with extrahepatic bile duct calculus treated in the First People's Hospital of Aksu from Feb. 2014 to Jan. 2017, were selected and di-vided into group A (n=52), group B (n=46) and group C (n=42). Group A received laparoscopic cholecystectomy and bile duct exploration through cystic duct, group B received laparoscopic cholecystectomy, common bile duct exploration and bile duct primary suture, and group C received laparoscopic cholecystectomy, common bile duct exploration and T tube drainage. The operation duration, intraoperative blood loss, abdominal drainage time, hospitalization duration, hospitalization expenses, the time return to normal life and complications were observed among the three groups. At the same time, the changes of adrenaline and cortisol levels of the three groups be-fore and after the operation were measured by hormone immunoassay, and the changes of interleukin-6 (IL-6) and C reactive protein (CRP) levels of the three groups before and after operation were measured by enzyme-linked immunoassay. Results The operation duration of group C was (120.04±12.26)min, which was obviously longer than those of group A and group B (P<0.05); the intraoperative blood loss of group B and group C were (63.28±23.14)mL and (62.42±21.01)mL, which were significantly more than that of group A (P<0.05); The abdominal drainage time of group A was (3.41±0.33) d, which was significantly shorter than those of group B and group C (P<0.05). The abdominal drainage time of group B was (4.12±0.54) d, which was significantly shorter than that of group C (P<0.05). The hospitalization time, hospitalization expenses and the time return to normal life of group C were (7.60±1.26) d, (21104.11±483.90) Yuan and (38.27±1.98) d, which were significantly more than those of group A and group B (P<0.05). After operation, the levels adrenaline, cortisol, IL-6 and CRP were (220.32±42.06) ng/mL, (562.17±142.51) nmol/L, (109.62±18.87) μg/L and (4.82±2.98) mg/L, which were sig-nificantly higher than those of group A (P<0.05). There was no significant difference in the incidence of postop-erative complications among the three groups (P>0.05). Conclusion Laparoscopic bile duct exploration through cystic duct for the treatment of calculus of bile duct has a good effect, and which is worthy of clinical use.关键词
腹腔镜/经胆囊管胆道探查术/胆管结石/临床疗效Key words
laparoscopy/bile duct exploration through cystic duct/calculus of bile duct/clinical efficacy分类
医药卫生引用本文复制引用
张新龙,陈智全,刘学军..腹腔镜经胆囊管胆道探查术治疗肝外胆管结石的疗效分析[J].肝胆胰外科杂志,2017,29(6):444-448,5.基金项目
新疆维吾尔自治区自然科学基金项目(2014211C193). （2014211C193）
